Individual
WILLIAM IAN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
Mailing address
2401 GILLHAM RD., PROVIDER ENROLLMENT, KANSAS CITY, MO 64108-4619
(816) 701-5200
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
M8634
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
186255903
CSHCN
TX
05
—
186255904
—
TX
01
—
8A4324
BCBSTX
TX
Enumeration date
04/24/2006
Last updated
07/21/2022
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